What does “diabetes of extreme duration” make you think? Anything with the word “extreme” in it makes me think it’s scary. A study published in 2007 (http://care.diabetesjournals.org/content/30/8/1995.full.pdf+html) actually showed that it doesn’t necessarily have to be so scary. These researchers found that out of their study population, almost one-half had no significant microvascular complications. They compared their finding that about 50% had retinopathy (eye disease) after 50-60 years of diabetes to the typical prediction that more than 90% of people with type 1 diabetes will eventually get retinopathy.
I have to admit that I have wondered about the complications statistics for a while. I struggle to believe that in this time, when we are able to manage diabetes so much more successfully, these rates wouldn’t go down.
The authors of this study mentioned that perhaps some people are protected from or experience much slower progression of retinopathy. They say this could result from a variety of factors (less hyperglycemia, more disease-inhibiting factors, or even a reporting bias – although they believe the latter is unlikely because of validated the findings with photographs of the eyeballs).
I think they left out a big one: attitude. I put attitude up there even before exercise (which is very high on the diabetes management list) and nutrition. I would love to see a follow up study that measures the attitudes of people who have lived successfully with diabetes for an extremely long time. This may even be one of the “factors that can neutralize the adverse effects of hyperglycemia” that the authors mention.
What do you think contributes to living successfully with diabetes?